Intramedullary nailing has become a common treatment for fractures of long bones, including the femur, tibia, humerus, fibula, and for arthrodesis procedures for the ankle and knee joints. Anatomies can vary significantly in size and form from patient to patient. Many conventional intramedullary nail systems have fixed trajectories for bone screws. Some conventional systems require multiple set screws to lock the bone screw at a selected orientation. Some conventional systems only allow the bone screw closest to an end of the intramedullary nail to be locked. Some conventional systems require polymer sleeves surrounding the bone screw to provide a friction fit. Some conventional systems can result in bone screws that don't target beneficial portions of a specific patient's anatomy or that are not locked within the intramedullary nail. Due to the configuration of some conventional systems, the bone screw does not provide any additional biomechanical advantage.